Macular thickness measurements in healthy Norwegian volunteers: an optical coherence tomography study

Alexandra Wexler, Trond Sand, Tor B Elsås, Alexandra Wexler, Trond Sand, Tor B Elsås

Abstract

Background: Ethnic, intersubject, interoperator and intermachine differences in measured macular thickness seem to exist. Our purpose was to collect normative macular thickness data in Norwegians and to evaluate the association between macular thickness and age, gender, parity, and contraception status.

Methods: Retinal thickness was measured by Stratus Optical Coherence Tomography in healthy subjects. Mean macular thickness (MMT) was analyzed by repeated measures ANOVA with three dependent regional MMT-variables for interaction with age, gender, parity and oral contraception use. Exploratory correlation with age by the Pearson correlation test, both before and after stratification by gender was performed. Differences in MMT between older and younger subjects, between oral contraception users and non-users, as well as parous and nulliparous women were studied by post-hoc Student's t-tests.

Results: Central MMT in Norwegians was similar to values earlier reported in whites. MMT in central areas of 1 and 2.25 mm in diameter were higher in males than in females. In younger subjects (< or =43 years) differences in MMT between genders were larger than in the mixed age group, whereas in older subjects (>43 years) the small differences did not reach the set significance level. No differences were found in minimal foveolar thickness (MMFT) between the genders in any age group.Mean foveal thickness (1 mm in diameter) was positively associated with age in females (r = 0.28, p = 0.03). MMFT was positively associated with age in all groups and reached significance both in females and in mixed gender group (r = 0.20, p = 0.041 and r = 0.26, p = 0.044 respectively).Mean foveal thickness and MMFT were significantly higher in parous than in nulliparous women, and age-adjusted ANOVA for MMFT revealed a borderline effect of parity.

Conclusions: Age and gender should be taken into consideration when establishing normal ranges for MMT in younger subjects. The gender difference in retinal thickness in young, but not older adults suggests a gonadal hormonal influence. The possible association between parity and retinal structure and its clinical relevance, should be studied further.

Figures

Figure 1
Figure 1
Macular areas on the Stratus OCT scan. Outer diameter of the outer, middle and inner rings are 3.45, 2.22 and 1 millimeters respectively. The foveal point in the center of F1 represents the mean minimal foveolar thickness (MMFT = F0). Mean foveal thickness (MFT) is measured in area F1. Regional thickness variables for regions MCT (mean central thickness) = (F2 + F3 + F4 + F5)/4, MPT (mean peripheral thickness) = (F6 + F7 + F8 + F9)/4 and MTT (mean total thickness) = (F1 + F2 + F3 + F4 + F5 + F6 + F7 + F8 + F9)/9 were calculated.
Figure 2
Figure 2
Mean foveal macular thickness (MFT) related to age in females. Linear regression is shown (Pearson correlation r = 0.28, p = 0.03).
Figure 3
Figure 3
Mean foveal thickness (MFT) and mean central thickness (MCT) in younger (≤43 years) males and females. MFT and MCT are significantly thicker in males in younger subjects.
Figure 4
Figure 4
Mean minimal foveolar thickness (MMFT) and mean foveal thickness (MFT) in parous and nulliparous women. MMFT and MFT are significantly thicker in parous women.

References

    1. van Velthoven ME, Faber DJ, Verbraak FD, van Leeuwen TG, de Smet MD. Recent developments in optical coherence tomography for imaging the retina. Prog Retin Eye Res. 2007;26(1):57–77. doi: 10.1016/j.preteyeres.2006.10.002.
    1. Koozekanani D, Roberts C, Katz SE, Herderick EE. Intersession repeatability of macular thickness measurements with the humphrey 2000 oct. Invest Ophthalmol Vis Sci. 2000;41(6):1486–1491.
    1. Paunescu LA, Schuman JS, Price LL, Stark PC, Beaton S, Ishikawa H, Wollstein G, Fujimoto JG. Reproducibility of nerve fiber thickness, macular thickness, and optic nerve head measurements using stratusoct. Invest Ophthalmol Vis Sci. 2004;45(6):1716–1724. doi: 10.1167/iovs.03-0514.
    1. Hsu SY, Tsai RK. Analysis of retinal nerve fiber layer and macular thickness measurements in healthy taiwanese individuals using optical coherence tomography (stratus oct) J Glaucoma. 2008;17(1):30–35. doi: 10.1097/IJG.0b013e31811243b4.
    1. Massin P, Vicaut E, Haouchine B, Erginay A, Paques M, Gaudric A. Reproducibility of retinal mapping using optical coherence tomography. Arch Ophthalmol. 2001;119(8):1135–1142.
    1. Polito A, Del Borrello M, Isola M, Zemella N, Bandello F. Repeatability and reproducibility of fast macular thickness mapping with stratus optical coherence tomography. Arch Ophthalmol. 2005;123(10):1330–1337. doi: 10.1001/archopht.123.10.1330.
    1. Bonnel S, Mohand-Said S, Sahel JA. The aging of the retina. Exp Gerontol. 2003;38(8):825–831. doi: 10.1016/S0531-5565(03)00093-7.
    1. Grunwald JE, Piltz J, Patel N, Bose S, Riva CE. Effect of aging on retinal macular microcirculation: A blue field simulation study. Invest Ophthalmol Vis Sci. 1993;34(13):3609–3613.
    1. Xu HP, Chen M, Forrester JV. Para-inflammation in the aging retina. Prog Retin Eye Res. 2009;28(5):348–368. doi: 10.1016/j.preteyeres.2009.06.001.
    1. Kaur I, Ghanekar Y, Chakrabarti S. Understanding the genetics of age-related macular degeneration: Some insights into the disease pathogenesis. International Journal of Human Genetics. 2008;8(1-2):161–169.
    1. Penfold PL, Madigan MC, Gillies MC, Provis JM. Immunological and aetiological aspects of macular degeneration. Prog Retin Eye Res. 2001;20(3):385–414. doi: 10.1016/S1350-9462(00)00025-2.
    1. Ting AYC, Lee TKM, MacDonald IM. Genetics of age-related macular degeneration. Curr Opin Ophthalmol. 2009;20(5):369–376. doi: 10.1097/ICU.0b013e32832f8016.
    1. Deschenes MC, Descovich D, Moreau M, Granger L, Kuchel GA, Mikkola TS, Fick GH, Chemtob S, Vaucher E, Lesk MR. Postmenopausal hormone therapy increases retinal blood flow and protects the retinal nerve fiber layer. Invest Ophthalmol Vis Sci. 2010;51(5):2587–600. doi: 10.1167/iovs.09-3710.
    1. Velez DR, Gallins P, Polk M, Ayala-Haedo J, Schwartz SG, Kovach JL, Spencer KM, Wang G, Agarwal A, Postel E. Inverse association of female hormone replacement therapy and oral contraceptive use with age-related macular degeneration and interactions with arms2 polymorphisms. Invest Ophthalmol Vis Sci. 2010;51(4):1873–1879. doi: 10.1167/iovs.09-4000.
    1. Dincer Y, Ozen E, Kadioglu P, Hatemi H, Akcay T. Effect of sex hormones on lipid peroxidation in women with polycystic ovary syndrome, healthy women, and men. Endocr Res. 2001;27(3):309–316. doi: 10.1081/ERC-100106008.
    1. Giovannucci E, Rimm EB, Stampfer MJ, Colditz GA, Ascherio A, Kearney J, Willett WC. A prospective study of cigarette smoking and risk of colorectal adenoma and colorectal cancer in u.S. Men. J Natl Cancer Inst. 1994;86(3):183–191. doi: 10.1093/jnci/86.3.183.
    1. Gupta PD, Johar K, Nagpal K, Vasavada AR. Sex hormone receptors in the human eye. Surv Ophthalmol. 2005;50(3):274–284. doi: 10.1016/j.survophthal.2005.02.005.
    1. Smith W, Mitchell P, Wang JJ. Gender, oestrogen, hormone replacement and age-related macular degeneration. Results from the blue mountains eye study. Aust N Z J Ophthalmol. 1997;25:S13–S15. doi: 10.1111/j.1442-9071.1997.tb01745.x.
    1. Feskanich D, Cho E, Schaumberg DA, Colditz GA, Hankinson SE. Menopausal and reproductive factors and risk of age-related macular degeneration. Arch Ophthalmol. 2008;126(4):519–524. doi: 10.1001/archopht.126.4.519.
    1. Evans JR, Schwartz SD, McHugh JDA, Thamby-Rajah Y, Hodgson SA, Wormald RPL, Gregor ZJ. Systemic risk factors for idiopathic macular holes: A case-control study. Eye. 1998;12:256–259.
    1. Eisner A, Toomey MD. The color appearance of stimuli detected via short-wavelength-sensitive cones: Comparisons with visual adaptation and visual field data for peri- or post-menopausal women under 70 years of age. Vision Res. 2008;48(26):2663–2672. doi: 10.1016/j.visres.2008.01.029.
    1. Jagle H, Heine J, Kurtenbach A. L:M-cone ratio estimates of the outer and inner retina and its impact on sex differences in erg amplitudes. Doc Ophthalmol. 2006;113(2):105–113. doi: 10.1007/s10633-006-9019-8.
    1. Elliot S, Catanuto P, Fernandez P, Espinosa-Heidmann D, Karl M, Korach K, Cousins SW. Subtype specific estrogen receptor action protects against changes in mmp-2 activation in mouse retinal pigmented epithelial cells. Exp Eye Res. 2008;86(4):653–660. doi: 10.1016/j.exer.2008.01.010.
    1. Elliot SJ, Catanuto P, Espinosa-Heidmann DG, Fernandez P, Hernandez E, Saloupis P, Korach K, Karl M, Cousins SW. Estrogen receptor beta protects against in vivo injury in rpe cells. Exp Eye Res. 2010;90(1):10–16. doi: 10.1016/j.exer.2009.09.001.
    1. Klein R, Klein BEK, Knudtson MD, Wong TY, Cotch MF, Liu K, Burke G, Saad MF, Jacobs DR. Prevalence of age-related macular degeneration in 4 racial/ethnic groups in the multi-ethnic study of atherosclerosis. Ophthalmology. 2006;113(3):373–380. doi: 10.1016/j.ophtha.2005.12.013.
    1. Loh FH, Khin LW, Saw SM, Lee JJM, Gu K. The age of menopause and the menopause transition in a multiracial population. A nation-wide singapore study. Maturitas. 2005;52(3-4):169–180. doi: 10.1016/j.maturitas.2004.11.004.
    1. Asefzadeh B, Cavallerano AA, Fisch BM. Racial differences in macular thickness in healthy eyes. Optom Vis Sci. 2007;84(10):941–945. doi: 10.1097/OPX.0b013e318157a6a0.
    1. Guedes V, Schuman JS, Hertzmark E, Wollstein G, Correnti A, Mancini R, Lederer D, Voskanian S, Velazquez L, Pakter HM. Optical coherence tomography measurement of macular and nerve fiber layer thickness in normal and glaucomatous human eyes. Ophthalmology. 2003;110(1):177–189. doi: 10.1016/S0161-6420(02)01564-6.
    1. Huynh SC, Wang XY, Rochtchina E, Mitchell P. Distribution of macular thickness by optical coherence tomography: Findings from a population-based study of 6-year-old children. Invest Ophthalmol Vis Sci. 2006;47(6):2351–2357. doi: 10.1167/iovs.05-1396.
    1. Kashani AH, Zimmer-Galler IE, Shah SM, Dustin L, Do DV, Eliott DE, Haller JA, Nguyen QD. Retinal thickness analysis by race, gender, and age using stratus oct. Am J Ophthalmol. 2010;149(3):496–502. doi: 10.1016/j.ajo.2009.09.025.
    1. Bjornsson OM, Syrdalen P, Bird AC, Peto T, Kinge B. The prevalence of age-related maculopathy (arm) in an urban norwegian population: The oslo macular study. Acta Ophthalmol Scand. 2006;84(5):636–641. doi: 10.1111/j.1600-0420.2006.00696.x.
    1. Dratva J, Real FG, Schindler C, Ackermann-Liebrich U, Gerbase MW, Probst-Hensch NM, Svanes C, Omenaas ER, Neukirch F, Wjst M. Is age at menopause increasing across europe? Results on age at menopause and determinants from two population-based studies. Menopause-J N Am Menopause Soc. 2009;16(2):385–394.
    1. Jacobsen BK, Heuch I, Kvale G. Age at natural menopause and all-cause mortality: A 37-year follow-up of 19,731 norwegian women. Am J Epidemiol. 2003;157(10):923–929. doi: 10.1093/aje/kwg066.
    1. Jacobsen BK, Heuch I, Kvale G. Age at natural menopause and stroke mortality - cohort study with 3561 stroke deaths during 37-year follow-up. Stroke. 2004;35(7):1548–1551. doi: 10.1161/01.STR.0000131746.49082.5c.
    1. Mikkelsen TF, Graff-Iversen S, Sundby J, Bjertness E. Early menopause, association with tobacco smoking, coffee consumption and other lifestyle factors: A cross-sectional study. BMC Public Health. 2007;7:149. doi: 10.1186/1471-2458-7-149.
    1. Sehi M, Guaqueta DC, Feuer WJ, Greenfield DS. A comparison of structural measurements using 2 stratus optical coherence tomography instruments. J Glaucoma. 2007;16(3):287–292. doi: 10.1097/IJG.0b013e3180391a72.
    1. Wang XY, Huynh SC, Burlutsky G, Ip J, Stapleton F, Mitchell P. Reproducibility of and effect of magnification on optical coherence tomography measurements in children. Am J Ophthalmol. 2007;143(3):484–488. doi: 10.1016/j.ajo.2006.11.042.
    1. Smith M, Frost A, Graham CM, Shaw S. Effect of pupillary dilatation on glaucoma assessments using optical coherence tomography. Br J Ophthalmol. 2007;91(12):1686–1690. doi: 10.1136/bjo.2006.113134.
    1. Youm DJ, Kim JM, Park KH, Choi CY. The effect of soft contact lenses during the measurement of retinal nerve fiber layer thickness using optical coherence tomography. Curr Eye Res. 2009;34(1):78–83. doi: 10.1080/02713680802579188.
    1. Barkana Y, Burgansky-Eliash Z, Gerber Y, Melamed S, Neudorfer M, Avni I, Bartov E, Morad Y. Inter-device variability of the stratus optical coherence tomography. Am J Ophthalmol. 2009;147(2):260–266. doi: 10.1016/j.ajo.2008.08.008.
    1. Muscat S, Parks S, Kemp E, Keating D. Repeatability and reproducibility of macular thickness measurements with the humphrey oct system. Invest Ophthalmol Vis Sci. 2002;43(2):490–495.
    1. Lima-Gomez V, Ojeda-Cruz P. Concordance of two retinal mapping techniques to detect diabetic macular edema. Cir Cir. 2009;77(2):83–87.
    1. Liew SHM, Gilbert CE, Spector TD, Mellerio J, Van Kuijk FJ, Beatty S, Fitzke F, Marshall J, Hammond CJ. Central retinal thickness is positively correlated with macular pigment optical density. Exp Eye Res. 2006;82(5):915–920. doi: 10.1016/j.exer.2005.10.014.
    1. Chamberlain MD, Guymer RH, Dirani M, Hopper JL, Baird PN. Heritability of macular thickness determined by optical coherence tomography. Invest Ophthalmol Vis Sci. 2006;47(1):336–340. doi: 10.1167/iovs.05-0599.
    1. Chan A, Duker JS, Ko TH, Fujimoto JG, Schuman JS. Normal macular thickness measurements in healthy eyes using stratus optical coherence tomography. Arch Ophthalmol. 2006;124(2):193–198. doi: 10.1001/archopht.124.2.193.
    1. Falsini B, Ziccardi L, Stifano G, Iarossi G, Merendino E, Minnella AM, Fadda A, Balestrazzi E. Temporal response properties of the macular cone system: Effect of normal aging and age-related maculopathy. Invest Ophthalmol Vis Sci. 2007;48(10):4811–4817. doi: 10.1167/iovs.07-0306.
    1. Curcio CA, Millican CL, Allen KA, Kalina RE. Aging of the human photoreceptor mosaic - evidence for selective vulnerability of rods in central retina. Invest Ophthalmol Vis Sci. 1993;34(12):3278–3296.
    1. Hee MR, Puliafito CA, Duker JS, Reichel E, Coker JG, Wilkins JR, Schuman JS, Swanson EA, Fujimoto JG. Topography of diabetic macular edema with optical coherence tomography. Ophthalmology. 1998;105(2):360–370. doi: 10.1016/S0161-6420(98)93601-6.
    1. Lam DSC, Leung KS, Mohamed S, Chan WM, Palanivelu MS, Cheung CYL, Li EYM, Lai RYK, Leung CKS. Regional variations in the relationship between macular thickness measurements and myopia. Invest Ophthalmol Vis Sci. 2007;48(1):376–382. doi: 10.1167/iovs.06-0426.
    1. Lattanzio R, Brancato R, Pierro L, Bandello F, Iaccheri B, Fiore T, Maestranzi G. Macular thickness measured by optical coherence tomography (oct) in diabetic patients. Eur J Ophthalmol. 2002;12(6):482–487.
    1. Liew SHM, Gilbert CE, Spector TD, Marshall J, Hammond CJ. The role of heredity in determining central retinal thickness. Br J Ophthalmol. 2007;91(9):1143–1147. doi: 10.1136/bjo.2007.114215.
    1. Wakitani Y, Sasoh M, Sugimoto M, Ito Y, Ido M, Uji Y. Macular thickness measurements in healthy subjects with different axial lengths using optical coherence tomography. Retina. 2003;23(2):177–182. doi: 10.1097/00006982-200304000-00007.
    1. Wong ACM, Chan CWN, Hui SP. Relationship of gender, body mass index, and axial length with central retinal thickness using optical coherence tomography. Eye. 2005;19(3):292–297. doi: 10.1038/sj.eye.6701466.
    1. Kelty PJ, Payne JF, Trivedi RH, Kelty J, Bowie EM, Burger BM. Macular thickness assessment in healthy eyes based on ethnicity using stratus oct optical coherence tomography. Invest Ophthalmol Vis Sci. 2008;49(6):2668–2672. doi: 10.1167/iovs.07-1000.
    1. Huang JJ, Liu X, Wu ZQ, Xiao H, Dustin L, Sadda S. Macular thickness measurements in normal eyes with time-domain and fourier-domain optical coherence tomography. Retina. 2009;29(7):980–987. doi: 10.1097/IAE.0b013e3181a2c1a7.
    1. Grunwald JE, Hariprasad SM, DuPont J. Effect of aging on foveolar choroidal circulation. Arch Ophthalmol. 1998;116(2):150–154.
    1. Provis JM. Development of the primate retinal vasculature. Prog Retin Eye Res. 2001;20(6):799–821. doi: 10.1016/S1350-9462(01)00012-X.
    1. Chan-Ling T, Hughes S, Baxter L, Rosinova E, McGregor I, Morcos Y, Van Nieuwenhuyzen P, Hu P. Inflammation and breakdown of the blood-retinal barrier during "physiological aging" in the rat retina: A model for cns aging. Microcirculation. 2007;14(1):63–76. doi: 10.1080/10739680601073451.
    1. Hogg RE, Dimitrov PN, Dirani M, Varsamidis M, Chamberlain MD, Baird PN, Guymer RH, Vingrys AJ. Gene-environment interactions and aging visual function a classical twin study. Ophthalmology. 2009;116(2):263–269. doi: 10.1016/j.ophtha.2008.09.002.
    1. Wolf-Schnurrbusch UEK, Roosli N, Weyermann E, Heldner MR, Hohne K, Wolf S. Ethnic differences in macular pigment density and distribution. Invest Ophthalmol Vis Sci. 2007;48(8):3783–3787. doi: 10.1167/iovs.06-1218.
    1. El-Ashry M, Hegde V, James P, Pagliarini S. Analysis of macular thickness in british population using optical coherence tomography (oct). An emphasis on interocular symmetry. Curr Eye Res. 2008;33(8):693–699. doi: 10.1080/02713680802323140.
    1. Grover S, Murthy RK, Brar VS, Chalam KV. Normative data for macular thickness by high-definition spectral-domain optical coherence tomography (spectralis) Am J Ophthalmol. 2009;148(2):266–271. doi: 10.1016/j.ajo.2009.03.006.
    1. Wachnik A, Biro G, Biro L, Korom M, Gergely A, Antal M. Effect of sex-hormones on copper, zinc, iron nutritional-status and hepatic lipid-peroxidation in rats. Nahr-Food. 1993;37(1):28–34. doi: 10.1002/food.19930370106.
    1. Yagi K, Komura S. Inhibitory effect of female hormones on lipid-peroxidation. Biochem Int. 1986;13(6):1051–1055.
    1. Bernstein L, Pike MC, Ross RK, Judd HL, Brown JB, Henderson BE. Estrogen and sex hormone-binding globulin levels in nulliparous and parous women. J Natl Cancer Inst. 1985;74(4):741–745.
    1. Byrnes EM, Babb JA, Bridges RS. Differential expression of oestrogen receptor alpha following reproductive experience in young and middle-aged female rats. J Neuroendocrinol. 2009;21(6):550–557. doi: 10.1111/j.1365-2826.2009.01874.x.
    1. Bridges RS, Byrnes EM. Reproductive experience reduces circulating 17beta-estradiol and prolactin levels during proestrus and alters estrogen sensitivity in female rats. Endocrinology. 2006;147(5):2575–2582. doi: 10.1210/en.2005-0917.
    1. de Kleijn MJ, Schouw YT van der, Graaf Y van der. Reproductive history and cardiovascular disease risk in postmenopausal women: A review of the literature. Maturitas. 1999;33(1):7–36. doi: 10.1016/S0378-5122(99)00038-9.
    1. Stein DM, Wollstein G, Ishikawa H, Hertzmark E, Noecker RJ, Schuman JS. Effect of corneal drying on optical coherence tomography. Ophthalmology. 2006;113(6):985–991. doi: 10.1016/j.ophtha.2006.02.018.
    1. Wu ZQ, Huang JJ, Dustin L, Sadda SR. Signal strength is an important determinant of accuracy of nerve fiber layer thickness measurement by optical coherence tomography. J Glaucoma. 2009;18(3):213–216. doi: 10.1097/IJG.0b013e31817eee20.

Source: PubMed

赞助者和合作者

医疗条件

药物干预

3
订阅